Hogg Foundation for Mental Health

Forum Addresses the Effects of Trauma Experiences on Children’s Mental and Physical Health

January 1, 2010

By Eric Pickhartz

Early traumatic experiences can affect children's mental health and cause behaviors that are harmful to the child and others. Understanding why these behaviors happen can help parents, teachers and other caregivers avoid situations that trigger them and respond more effectively if they do occur.

Stakeholders, policymakers, advocacy organizations and service providers met in December to discuss childhood trauma and mental health at the Texas Children's Mental Health Forum in Austin. The monthly forum is hosted by the Hogg Foundation, Texans Care for Children and their newest partner, the Texas Health Institute. The forum promotes broad-based leadership to improve children's mental health policies and services in Texas.

Dr. Christine Dobson, director of programs for the ChildTrauma Academy in Houston, told forum attendees that trauma-informed care is an effective approach to working with children. Trauma-informed care recognizes that many behaviors and responses are closely related to traumatic experiences that can cause mental health, substance use and physical health conditions.

Dobson demonstrated how to develop therapeutic interventions that are unique to the strengths and vulnerabilities of each child and can specifically help them deal with their issues. This could potentially change the way children with mental health needs are treated.

Instead of focusing on behaviors and ways to modify them, the focus is on why those behaviors happen in the first place to better understand the problem as well as the solution. In some cases, Dobson said such recovery methods might reduce the need for medication.

Not all behaviors can be predicted or eliminated, however. Caregivers may need to use behavioral management methods in some situations. Darcie DeShazo, a licensed clinical social worker, chairs the children's subcommittee of the Texas Seclusion and Restraint Reduction Leadership Group. She also is a supervisor and therapist at The Settlement Home, a nonprofit organization that provides residential care for children in Central Texas.

DeShazo spoke to forum attendees about effective alternatives to traditional seclusion and restraint techniques that can cause trauma, injury and even death by using physical force, restricting movement or involuntarily medicating or isolating children and adults to control their behavior. She said these methods are dangerous to clients, staff and bystanders but are still used in many schools, psychiatric hospitals, juvenile detention facilities and residential treatment facilities.

The National Technical Assistance Center within the National Association of State Mental Health Program Directors has developed six core strategies to create violence-free and coercion-free environments that reduce the need for traditional seclusion and restraint methods, DeShazo said.

Examples include changing organizational culture and practice, gaining support for change from top management, and involving consumers in developing new policies, procedures and programs. Components of success include comfort rooms, peer-mentoring incentive programs, trauma assessments, staff training and debriefing forms following incidents.

Forum attendees identified barriers to trauma-informed care, such as lack of funding for alternative therapy and behavioral management techniques and provider training. They also identified the need to prevent youth from experiencing recurring traumas after they receive services or complete youth recovery programs.

These and other issues identified by the forum in the coming year will be compiled into a policy agenda developed by Texans Care for Children prior to the next legislative session. To learn more about the Texas Children's Mental Health forum, go to www.hogg.utexas.edu/TxChildMHForum.html.

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The use of seclusion and restraint to manage behavior is dangerous. Learn what Texas organizations are doing to address the issue in a new brochure published by the Hogg Foundation and the Texas Seclusion and Restraint Reduction Leadership Group.

The group works to reduce seclusion and restraint in all settings by identifying and promoting alternatives through research, policy analysis, consultation and education. Members share information and coordinate activities.

The brochure is online and can be downloaded at www.hogg.utexas.edu/programs_S&R.html.